Comparison of 18F-FDG PET with 99mTc-MIBI SPECT in the Detection of Primary Oral Cancer and Lymph Node Metastasis

比較鎝-99m-MIBI單光子放射斷層掃描與氟18-FDG正子放射斷層掃描對早期口腔癌及淋巴結轉移之偵測

王克彬(Keh-Bin Wang) ； 蔡世傳(Shih-Chuan Tsai) ； 林萬鈺(Wan-Yu Lin)

《核子醫學雜誌》 23卷3期 (2010/09) Pp. 123-127

https://doi.org/10.6332/ANMS.2303.001

摘要

目的：口腔癌由於早期可在口腔中被視診及觸診發現，所以整體來說預後良好。但就長遠的存活率及生活品質的觀點來看，早期口腔癌的分期，對於臨床的預後和治療計畫的訂定有很重要的影響。由於傳統電腦斷層及核磁共振對於淋巴結的轉移侵犯無法有效診斷。所以早期口腔癌需要精確的造影方法，便於診斷是否有轉移的情形。鎝-99m-MIBI曾被報告對早期口腔癌是有用的追蹤劑。近來氟-18-氟化去氧葡萄糖正子斷層掃描對評估癌症具有相當優異的價值。本研究比較鎝-99m-MIBI單光子放射斷層掃描和氟-18-氟化去氧葡萄糖正子放射斷層掃描在評估早期口腔癌的診斷能力。方法：本研究收集30位早期口腔癌的病人。所有的病人均接受鎝-99m-MIBI全身掃描和氟-18-氟化去氧葡萄糖正子放射斷層掃描。鎝-99m-MIBI全身掃描和氟-18-氟化去氧葡萄糖正子放射斷層掃描分別由兩位核醫科醫師判讀。結果：對於口腔癌原發病灶，氟-18-氟化去氧葡萄糖正子放射斷層掃描與鎝-99m-MIBI全身掃描的靈敏度分別是93.30%和83.30%。在偵測淋巴結是否有轉移方面，氟-18-氟化去氧葡萄糖正子放射斷層掃描與鎝-99m-MIBI全身掃描的靈敏度分別是83.3%和27.8%；特異性分面分別是81.8%和95.4%。結論：氟-18-氟化去氧葡萄糖正子放射斷層掃描和鎝-99m-MIBI全身掃描對於原發病灶均有不錯的敏感度。在淋巴結是否有轉移之偵測上，鎝-99m-MIBIM全身掃描靈敏度不如氟-18-化去氧葡萄糖正子放射斷層掃描，但特異性卻優於氟-18-氟化去氧葡萄糖正子放射斷層掃描。

關鍵字

氟-18氟化去氧葡萄糖正子放射斷層掃描 ； 鎝-99m-MIBI全身掃描 ； 口腔癌 ； 頭頸部淋巴結

並列摘要

Purpose: The purpose of this work was to compare [18F]2-deoxy-2-fluoro-D-glucose (FDG) PET and 99mTcmethoxyisobutylisonitrile (MIBI) SPECT in the detection of primary oral cancer and cervical lymph node metastasis in the same patients. Methods: Thirty patients (28 males and 2 females, aged between 31 and 75 with a mean age of 52.3 years) with newly-diagnosed oral cancer were enrolled in this study. The FDG PET and MIBI SPECT examinations were performed in all patients before operation. The time interval between these two examinations was within 3 days. The diagnostic accuracy for detecting cervical lymph node metastases was based on surgical results or comparing the results of CT and/or MRI and physical findings. Both FDG PET and MIBI SPECT images were interpreted by at least two nuclear medicine specialists. Results: The sensitivities of FDG PET and MIBI SPECT were 93.3% and 83.3%, respectively, for the detection of primary oral cancer. In the detection of the lymph node involvement, the sensitivities of FDG PET and MIBI SPECT were 83.3% and 27.8%, respectively, while the specificities were 81.8% and 95.4%, respectively. Conclusion: Our results suggest that the sensitivity of both FDG PET and MIBI SPECT modalities were good for the detection of primary oral cancer, although FDG PET had better sensitivity than MIBI SPECT. In the detection of lymph node involvement, MIBI SPECT had much lower sensitivity but showed better specificity than those of FDG PET.

並列關鍵字

FDG PET ； MIBI SPECT ； oral cancer ； head and neck lymph node